1. Paramedic Care Principles & Practice Volume 5 Special Considerations / Operations Second Edition Chapter 3 Geriatric Emergencies

2. Figure 3-1 Many older adults live active lives, participating in sports and exercises popular among people of all ages. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

3. Figure 3-2 Many elderly people form social networks by joining a senior center or by taking part in volunteer programs. (© Corbis/The Stock Market) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

4. Figure 3-3 An example of a Do Not Resuscitate order. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

5. Figure 3-4 VA hospitals provide a variety of medical services, including nursing home facilities, to Americans who served in the nation’s military. (© Michal Heron) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

6. Figure 3-5 Meals on Wheels helps ensure that elderly people receive adequate nutrition by providing from one to three meals a day. (© Craig Jackson/In the Dark Photography) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

7. Figure 3-6 In some communities, paramedics offer free medical screening programs, such as blood pressure checks, to the elderly. (© Craig Jackson/In the Dark Photography) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

8. Figure 3-7 “Childproof” pill vials are sometimes “elder-proof” as well. Blister-pack packaging makes it easier for elderly patients, especially those suffering from arthritis, to take their medicines, thus furthering compliance. (© Craig Jackson/In The Dark Photography) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

9. Figure 3-8 Cataracts, which cloud the lens, can diminish eyesight in the elderly. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

10. Figure 3-9 If possible, talk to the elderly patient rather than talking about the patient to others. (© Jeff Forster) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

11. Figure 3-10 Allow the elderly patient with hearing difficulties to put on the stethoscope while you speak into it like a microphone. (© Craig Jackson/In the Dark Photography) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

12. Figure 3-11 Do not assume that an altered mental status is a normal age-related change. A number of serious underlying problems may be responsible for changes in consciousness. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

13. Figure 3-12 Some changes in the body systems of the elderly. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

14. Figure 3-13 Dyspnea can be caused by a number of respiratory and cardiac problems in the elderly. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

15. Figure 3-14 The COPD patient may use a nasal cannula with a home oxygen unit. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

16. Figure 3-15 Regular stretching and weight-bearing exercises help prevent the development of osteoarthritis. (© Corbis/The Stock Market) Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

17. Figure 3-16 When you encounter evidence of serious head injury, maintain a suspicion of geriatric abuse until proven otherwise. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

18. Figure 3-17 (a) In an elderly patient with curvature of the spine, place padding behind the neck when immobilizing a patient to a long spine board. (b) Additional padding, such as rolled blankets or towels behind the head, may be needed to keep the head in a neutral, in-line position. (c) Secure the patient’s head with a head immobilizer device. To prevent spinal damage, maintain manual stabilization until the head is secured. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

19. Figure 3-17 (continued) (a) In an elderly patient with curvature of the spine, place padding behind the neck when immobilizing a patient to a long spine board. (b) Additional padding, such as rolled blankets or towels behind the head, may be needed to keep the head in a neutral, in-line position. (c) Secure the patient’s head with a head immobilizer device. To prevent spinal damage, maintain manual stabilization until the head is secured. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

20. Figure 3-17 (continued) (a) In an elderly patient with curvature of the spine, place padding behind the neck when immobilizing a patient to a long spine board. (b) Additional padding, such as rolled blankets or towels behind the head, may be needed to keep the head in a neutral, in-line position. (c) Secure the patient’s head with a head immobilizer device. To prevent spinal damage, maintain manual stabilization until the head is secured. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

21. Figure 3-18 Subcapital femoral neck fracture. Patients with a displaced femoral neck fracture present with groin pain and a shortened externally rotated leg. Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry Paramedic Care, Principles & Practice: Special Considerations / Operations Copyright ©2006 by Prentice-Hall, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.